title: Abdominal binder use in people with spinal cord injuries: a systematic review and meta-analysis.
abstract: METHODS
  Systematic review and meta-analysis.
  
  
  OBJECTIVE
  To review the evidence for the use of an abdominal binder on breathing, speech and cardiovascular function in people who have suffered a spinal cord injury (SCI).
  
  
  METHODS
  Brisbane, Australia.
  
  
  METHODS
  A search of multiple databases (Medline, Cinahl, Cochrane, Embase, PEDro) was undertaken accompanied by the reference list evaluation of each relevant publication identified. Methodological quality of studies identified was assessed using the PEDro scale. The size of effect of an abdominal binder on outcomes was also calculated where sufficient data were reported. Further descriptive analysis was performed.
  
  
  RESULTS
  Eleven studies met the review inclusion criteria and employed either crossover or within subject designs. Comparison of studies involving elastic and non-elastic binders was performed. A PEDro mean score of 4.3 out of 8 (range: 3-6) was found. Meta-analysis indicated that the use of abdominal binders improved vital capacity (VC) by (weighted mean difference (95% confidence interval (CI)) 0.32 (0.09, 0.55) litres, decreased functional residual capacity (FRC) by 0.41 (0.14, 0.67) litres, but did not significantly influence total lung capacity (TLC).
  
  
  CONCLUSIONS
  This review found some evidence that the use of an abdominal binder improves VC, but decreases FRC when assuming the sitting or tilted position in people who have suffered SCI. Overall, the quality of the studies was poor. Available evidence is not yet sufficient to either support or discourage the use of an abdominal binder in this patient population. Further studies utilizing more methodologically rigorous designs are required.
authors.affiliation: Department of Physiotherapy, Princess Alexandra Hospital, Brisbane, Australia. painsolutions@bigpond.com
authors.forename: B M
authors.initials: BM
authors.lastname: Wadsworth
authors.forename: T P
authors.initials: TP
authors.lastname: Haines
authors.forename: P L
authors.initials: PL
authors.lastname: Cornwell
authors.forename: J D
authors.initials: JD
authors.lastname: Paratz
mesh_terms: D000005:Abdomen / Q000503:physiopathology*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D004548:Elasticity; D006801:Humans; D012119:Respiration; D012149:Restraint, Physical / Q000379:methods*; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation